Refinement of the Milan Criteria: Role of α-Fetoprotein In Liver Transplantation for Hepatocellular Carcinoma

• DOI: 10.1016/j.transproceed.2022.04.011
• Publication Date: 2022-05-07T20:45:31Z
• Authors: Simone Reges Perales; Fernanda Dias Ter...; Elaine Cristina d...; Aline Garcia; Paolla Ravida Alv...; Marlone Cunha-Silva; Tiago Sevá-Pereira; Alexandre Foratto; Débora Puzzi Fern...; Daniela Ciancio M...; Cristhian Jaillit...; Larissa Bastos El...; Felicio Chueiri Neto; Ilka Santana de F...
• Keywords: 03 medical and health sciences; Carcinoma, Hepatocellular; 0302 clinical medicine; Liver Neoplasms; Humans; alpha-Fetoproteins; Neoplasm Recurrence, Local; Liver Transplantation; Retrospective Studies; 3. Good health

Hepatocellular carcinoma (HCC) is the most common primary neoplasm of the liver, mainly secondary to cirrhosis caused by hepatitis C virus. Liver transplant (LT) is considered the best treatment because, in addition to removing the tumor, it also removes the underlying cirrhotic liver. The Milan criteria for LT have limitations because they do not consider the biological characteristics of the tumor. Thus, our objective was to evaluate the association of α-fetoprotein (AFP) levels before LT performed for HCC with recurrence of this tumor, and, based on the results, a new predictive model that combines the AFP values at the list entry with the usual criteria of tumor size and number of nodules was validated. In present study, the Score AFP model, we were able to correlate a greater occurrence of relapse with scores of 3 and 4 (P = .0001), indicating the usefulness of using AFP as a predictor of recurrence.